Numerous microorganisms, such as bacteria, viruses and fungi, inhabit the oral cavity, and it has been pointed out that poor oral hygiene and chronic periodontitis increase the risk of oral squamous cell carcinoma (OSCC). However, the molecular mechanism whereby the risk of OSCC is increased under such conditions has not yet been clarified. Microbes in the oral cavity may elicit both innate and acquired immune responses, resulting in the establishment of uncontrolled inflammation such as chronic periodontitis. Further microbial attack and various host-derived factors may subsequently contribute to events such as genetic and epigenetic alterations, inhibition of apoptosis, increased cell growth, promotion of invasion and metastasis, and lymphangiogenesis, thus linking the chronic inflammation to OSCC. Here we review the various factors involved in promoting the development and progression of OSCC. The facts suggest the importance of early prevention and treatment of chronic periodontitis to maintain oral health and prevent serious diseases such as OSCC.